Walking Mechanics After ACL Reconstruction Differ According to Medial Meniscal Treatment

What is it about?

We compared walking patterns in athletes early after ACL reconstruction who had 1) no involvement, 2) partial meniscectomy, or 3) repair of their medial meniscus at the time of ACL reconstruction. We found that aberrant walking mechanics--those associated with future osteoarthritis development--were present in those with ACL reconstruction with partial medial meniscectomy and medial meniscus repair. However, the aberrant walking mechanics were opposite in those with meniscectomy versus repair. Specifically, those with ACLR and medial meniscus repair walked with lower medial compartment contact forces and lower knee adduction moments in the involved (relative to uninvolved) limb, whereas those with ACLR and medial meniscectomy did the opposite.

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Why is it important?

Anterior cruciate ligament (ACL) reconstruction (ACLR) leads to altered walking patterns and higher rates of osteoarthritis (OA). Concomitant medial meniscus injury increases risk for OA. Both ACLR and partial meniscectomy alter walking mechancis, a known risk factor for OA; however, the effect of ACLR with and without medial meniscus pathology and treatment at the time of ACLR was unknown. This was the first study to evaluate the effect of medial meniscal treatment at the time of ACLR on walking patterns. Our findings may partially explain the high rates of OA after ACLR with medial meniscus pathology and inform future studies evaluating targeted interventions.

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